CORVALLIS, Ore. – An analysis of high school soccer players suggests that incorporating a lower extremity injury prevention program results in fewer anterior cruciate ligament tears and a big reduction in health care expenses.
The study by Oregon State University researchers shows that every dollar spent on preventing ACL tears saves more than seven times that much in treatment and rehabilitation costs, which the researchers note could mean a huge return on investment for insurance companies willing to fund lower extremity injury prevention programs, or IPPs.
The scientists note that the incident rate of ACL tears continues to rise, as does high school athletes' risk of sustaining the injury. The ACL, which runs diagonally in the middle of the knee, connects the femur to the tibia, providing rotational stability and keeping the tibia from sliding in front of the femur. ACL injuries are common in sports that involve jumping, sudden stops and rapid changes of direction.
Led by Tao Li, an associate professor in the OSU College of Health, the study looked at injury data from boys and girls who played high school soccer in the United States during the 2018-19 school year. The year was chosen because it was the most recent for which estimates of both participation numbers and ACL tears were available.
According to the 2018-19 High School Athletics Participation Survey, 853,182 students participated in soccer that year – 459,077 boys and 394,105 girls. A study published in the Orthopaedic Journal of Sports Medicine estimated there were 15,000 soccer-related ACL injuries that year, and that more than 70% of such injuries occurred in girls from 2007 to 2019.
Taking both public and private insurers into account, Li and collaborators Collin Peterson and Marc Norcross, also of the College of Health, found a return on investment of $7.51 for every dollar spent on an injury prevention program, suggesting a lower extremity IPP can be a valuable alternative to a conventional warmup routine.
Jump squats, lateral hops and shuffles, hip abductions, single-leg excursions and high-knee running drills are among the exercises that help make an athlete less prone to ACL injury.
The study showed that had all of the nation's high school soccer players during the study period been training under a lower extremity injury prevention plan, the total monetary benefit would have been greater than $60 million. Expenses associated with IPP implementation include teaching materials and the cost of training coaches to instruct their players.
"Our study may incentivize policy makers and stakeholders and facilitate public-private cooperation to increase adoption of injury prevention programs," Li said.
The paper was published in the Journal of Athletic Training and the research was supported by a National Athletic Trainers' Association Research and Education Doctoral Grant to Peterson, a student at the time of the study. Li was his faculty mentor on the grant.
2025 marks the 50th anniversary of OSU's athletic training program.
